Detection of malignant bone tumors: MR imaging vs scintigraphy

AJR. American Journal of Roentgenology
J A FrankA J Dwyer

Abstract

One hundred six patients with a known or suspected diagnosis of bone cancer (11 patients with biopsy-proved primary tumors, 95 patients with metastatic disease) were evaluated with scintigraphy and MR imaging to determine the relative sensitivity of each technique in the detection of bone disease. MR imaging was performed at 0.5 T as part of the entry evaluation into Intramural Research Board protocols (30%), for evaluation of cord compression, or because of an equivocal scintigram. MR was performed with T1-weighted (e.g., 300-500/10-20 [TR/TE]), T2-weighted (e.g., 2000/80) spin-echo (SE), and a short-TI inversion recovery (STIR) pulse sequence. Scintigrams were performed with 99mTc-methylene diphosphonate. A retrospective analysis showed that in 30 (28%) of 106 patients, MR imaging performed over a limited region of interest revealed a focal abnormality consistent with tumor that was not observed on scintigraphy. Only one patient had an abnormality on scintigraphy, caused by a metastasis, that was not found on MR images. In 73 (69%) of the 106 patients, the results of MR imaging and scintigraphy were equivalent; in 41 cases results of both techniques were normal. A McNemar analysis of the discordant cases showed MR imaging to ...Continue Reading

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